Researchers Develop New Computer-based Vision Screening Test for Young Children

Easy-to-Use and accurate test can be used in schools
or pediatricians’ offices, reports new study in theJournal of AAPOS

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San Francisco, CA, April 28, 2015

Many
eye disorders in young children are asymptomatic and may remain undetected
without testing. Since effective treatments are available for many of those
conditions, early identification and intervention are critical to prevent potentially
permanent vision problems. A new report published in the Journal of the American Association for Pediatric Ophthalmology and
Strabismus
(AAPOS) describes the effectiveness of a new computer-based
vision-screening test, the Jaeb Visual Acuity Screener (JVAS), which is suitable
for use in schools and pediatrician’s offices.

“Broad
adoption of this tool would result in a more standardized approach to pediatric
vision screening in diverse medical and community office settings,” commented
lead investigator Tomohiko Yamada, OD, of the Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota. “In
comparison to traditional vision testing methodologies, this software-based
tool provides the advantage of running on any windows-based PC in a
pediatrician’s examination room—avoiding testing in distracting office hallways.”

JVAS
is a computerized screening program developed by the Jaeb Center for Health
Research that is designed to identify children with subnormal visual acuity in
a rapid and reproducible manner. It uses a set testing algorithm to minimize
subjective tester bias. It also uses age-specific visual acuity standards to
provide a simple pass/fail result for four age groups (3, 4, 5 or 6, and 7 and
over).

Investigators
used the JVAS program to screen the vision of 175 children, ages 3 to 7, who
then received a complete eye examination by an optometrist, which served as the
study gold standard. The examining optometrist was kept unaware of the initial JVAS
vision screening results. No children who already wore glasses, had been
treated for amblyopia, or had undergone ocular surgery were included in the
screening. The average screening time was 84 seconds, with a range of 23 to 357
seconds across all age groups. There were three different failure criteria
evaluated: (1) failure to identify at least three of any four normal threshold
letters in either eye; (2) failure to identify at least three of any five
normal threshold letters in either eye; (3) failure to identify at least four
of any five normal threshold letters in either eye.

Of
the 65 children failing the gold standard examination, 86% failed for reduced
visual acuity (56), 35% for hyperopia (23), 23 % for astigmatism (15), 11% for anisometropia
(7), 9% for myopia (6), and 5% for strabismus (3), with some patients failing
the gold standard for more than one reason. For the 56 children with reduced
visual acuity, the primary cause assigned hierarchically was uncorrected
refractive error in 31 of 56 (55%), unilateral amblyopia in 7 (13%), bilateral
amblyopia in 8 (14%), and for 10 (18%) the cause of reduced visual acuity was felt
to be attention-maturation without specific reason.

For
any screening test, high sensitivity and specificity are desirable. High
sensitivity is the ability to correctly identify those children with the target
condition(s). High specificity is the ability to correctly identify those who
do not have the target condition(s). The investigators found a sensitivity of
88% to 91% and a specificity of 73% to 86%. The proportion of false positives (screening
test failed but gold standard examination passed) was low for the JVAS, ranging
from 9% to 17%, depending on which failure criterion was used. The criterion of “failure to identify at
least three of any five normal threshold letters in either eye” gave the best
balance of sensitivity and specificity.

The
testing program is offered free of charge and the investigators encourage elementary
school nurses, pediatricians, and other professionals who work with children
ages 3-7 years to download and use the JVAS for their vision screening needs. The
program can be downloaded at www.pedig.net/JVAS.aspx.

Full text of the article is
available at to credentialed journalists upon request; contact Eileen Leahy at
+1 732 238 3628 or e.leahy@elsevier.com
to obtain a copy. Journalists
wishing to set up interviews with the authors should contact Bob Nellis, Mayo Clinic
Research Public Affairs, at +1 507 284 5005 or Nellis.Robert@mayo.edu.

About the Journal of AAPOS
(www.jaapos.org)
Journal
of AAPOS presents expert information on children's eye
diseases and on strabismus as it impacts all age groups. Major articles by
leading experts in the field cover clinical and investigative studies,
treatments, case reports, surgical techniques, descriptions of instrumentation,
current concept reviews, and new diagnostic techniques. The journal is the
official publication of the American Association for Pediatric Ophthalmology
and Strabismus.

About the American Association for
Pediatric Ophthalmology and Strabismus (www.aapos.org)The goals of the AAPOS, the American Association for Pediatric
Ophthalmology and Strabismus, are to advance the quality of children's eye
care, support the training of pediatric ophthalmologists, support research
activities in pediatric ophthalmology, and advance the care of adults with
strabismus.

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